Nutritional Problems In The Older Population

DR NOR HAKIMA MAKHTAR


Around 30% of people aged 60 years or older suffer from malnutrition. These people tend to become sick more often and take longer to recover from an illness compared to those who are well nourished.

Good nutrition is important for optimal health. It improves wound healing, helps to preserve bone mass and maintain muscle strength thus reduces the risk of falls and fractures.

 

Risk factors for poor nutrition status in seniors

Important risk factors that should be addressed are:

• Food restrictions: self-imposed or due to health conditions
• Oral health/ hygiene problems
• Impaired ability to chew and swallow
• Erratic eating patterns: frequency and number of meals eaten vary
• Poor knowledge of adequate nutrition
• Lack of motivation to follow medical nutrition therapy
• Obesity
• Changes in appetite and digestion
• Social isolation
• Deterioration in functional capacity
• Decreased motivation, fatigue or apathy

Long-term inadequate intake of protein may result in loss of muscle mass, impaired immune function, and poor wound healing. Recommended protein intake for elderly is 0.8 g/kg of ideal body weight.

Protein needs can be met with adequate consumption of meat, fish, eggs, milk products and pulses (chick peas, lentils). Recommended daily amount: 2 portions/day.

 

Nutrients of concern

Calcium

Calcium absorption diminishes with aging. The dietary calcium requirement is higher (1200 mg daily) for women over 50 years and men over 70 years. Milk and milk products such as yoghurt, custard and cheese contain significant amounts of calcium.

High calcium

Ultraviolet rays are the main source of vitamin D. About 15% of skin needs to be exposed for approximately 10–15 minutes a day. Foods contain a small amount of vitamin D found in fatty fish, liver, eggs and fortified margarine.

For adults aged 50 years and older at risk of vitamin D deficiency, supplementation of 800 to 1000 IU vitamin D per day is recommended. Those people who is unable to meet their calcium and vitamin D requirements with dietary sources should discuss supplement use with their health care providers

Vitamin D food

Elderly frequently do not feel thirsty as the ability to detect thirsty is declined. Fluid recommendations for the healthy older adult are at least 1500 mL per day or 8 glasses of water per day.

Strategies to facilitate adequate fluid intake for older adults:

• Education of the client, their family and staff on the need for fluids
• Offering a variety of fluids at meals and between meals not limited to water, tea and coffee, but also includes juice & vegetable, soup and milk

Zinc

Zinc is needed for adequate wound healing, immunity, and a healthy appetite.
Common plant sources of zinc are legumes, nuts, seeds and oatmeal.

Zink food

 

Special conditions that affect nutritional intake in older people

Forgetfulness

Poor memory can hurt a senior's ability to eat a variety of foods. They forget to eat on a regular schedule, forgetting what to buy at the store and sometimes eating the same foods over and over and skipping their meals.

Care giver should prepare schedule meals at the same time each day and give visual and verbal reminders about when it's time to eat.

Depression

In a person with depression, there is decrease in appetite, making one feel apathetic about caring for one's health. Left untreated, it can lead to many other nutritional and health problems.
Family members should make eating a social event by making meals a family occasion. Bring a meal over to their home and invite them to your house on a regular basis. The elderly become more interested in food when other people are around.

 

Solutions for poor nutrition in elderly

Reduced senses of smell, taste and poor dental health will directly affect the person’s ability to enjoy food.

Few solutions that can improve appetite in old people:

 

 

 


DR. NOR HAKIMA is a Geriatrician based at the Malacca General Hospital.

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